Urological Survey

ing BOO, the positive predict value of others sonographic measurements such detrusor wall thickness (DWT), bladder weight and intravesical prostatic protrusion (IPP) has been investigated. In this study the authors evaluated a group of 100 patients with lower urinary tract symptoms due to benign prostatic hyperplasia. They found that the AUC for IPP was 0.835 with a cutoff of 12 mm having 0.65 sensitivity and 0.77 specificity and 88 % positive predictive value. The AUC for DWT was 0.845 and at a 6 mm cutoff they noted 0.73 sensitivity and 0.82 specificity. Patients with 1 of the 2 tests positive (IPP 12 mm or more, or DWT 7 mm or more) have an approximately 90 % chance of bladder prostatic obstruction on pressure flow study. In the evaluation of IPP, the authors excluded men with a median lobe, which may cause ball valve type of obstruction and can be eas-ily determined by suprapubic US in the sagittal plane. Special attention was given to the role of protrusion of lateral lobes into the bladder. Radiologists and urologists, who perform urological ultrasound, should be aware of the technical aspects of how to obtain these measurements. The estimative of DWT, is yet the only one of these two parameters which has been recommended by the “American College of Radiology 2008- Appropri-ateness Criteria”, requires adequate maximum bladder volume, adequate place of the transducer for bladder wall measurement and optimized ultrasound transducer frequency